Traumatic grief during COVID-19

I don’t presume to know the individual experiences and feelings of providers and frontline workers right now during this crisis, but, as someone who has specialized in psychological trauma and traumatic grief for many years, here are some thoughts which might be helpful for some.

Experiencing the unfathomable and enormity of devastating loss generates many feelings, including disbelief, shock, hopelessness, fury, despair, and, for some, giving up. How the aftermath of those experiences unfold over time is shaped by many variables, but the imprint is indelible.

Witnessing others’ suffering while often evoking empathy and compassion can also stir up feelings of helplessness, anger, anxiety, fear or even terror in the witnesses themselves (e.g., that this could happen to me, to us, to our families). Further, for some, there comes a jolting recollection of equivalent past experiences, a reminder that unexpected tragedy or loss has happened before and might happen again.

The loss of someone is never a singular loss. It’s, of course, the physical absence of a person – but when losing a loved one, it’s also the loss of an envisioned future, a shared ongoing experience of living life. Traumatic loss can and often does extinguish our illusions about control and serves as an explicit reminder of inevitable endings and the constancy of impermanence.

Since the inception of the Center for Homicide Bereavement at Cambridge Health Alliance 18 years ago, our staff of three clinicians has worked with hundreds of family members, friends, and witnesses – survivors of the abrupt death of loved ones. They come to our program seeking assistance, seeking solace in often undefined ways as to what might help – or pleading with us, with God, with the universe to “fix it,” to bring the lost ones back, to stop the unbearable pain, to offer an assurance that pain and grief have an endpoint. After hearing and witnessing the palpable suffering of person after person, we came to fully know the imperative to examine our own frailties, our own strengths, our own fears and vulnerabilities – and to realize how much we needed to keep learning.

Speaking for myself: In the beginning years, fears and feelings of anxiety and vulnerability, questions about life, death, afterlife, faith – of injustice, unfairness, randomness – of guilt alongside relief/gratitude (not my turn) surfaced with frequency and in ways that were distressing and saddening. Over time, and especially it seemed in this program, I began to more fully recognize that the cumulative impact of witnessing, of seeing, of listening to the past, present and anticipated life-long legacies of traumatic, incomprehensible loss had begun to alter, distort, and at times skew my way of perceiving others and of perceiving the world.

It wasn’t just the victims and survivors, I realized, who had to explore a whole different landscape; I had a learning curve, too. It wasn’t their curve; it wasn’t comparable. But it was one that paralleled in some respects, and one that I couldn’t do alone. I needed the help and support of trusted others – and I still do.

During this pandemic, we are seeing very brave providers in many spheres – likely not fearless, not without grave worry, not without anger, not without mixed feelings – but good, decent, skilled people who are giving all of us, up close or at some distance, life-affirming experiences of generosity. I don’t call them heroes because it seems to me that designation constricts and streamlines their individuality, their unique elements, the entirety of each of them. It doesn’t leave space for the complexities of the multiple roles, professional and personal, each inhabits and the variety of life experiences and feelings and messiness we all carry. And yet, or in spite of these sometimes competing feelings, they show up, they offer gifts of humanity to those who struggle and suffer. (And, lest we overlook or underestimate, there are all the numerous quiet, under the radar generous and caring outpourings of support and assistance by those whose commitment to patients is long-standing and steadfast.)

A final thought: Public/institutional narratives and individual/personal narratives are not necessarily in sync – especially as crises and responses unfold over time. There can be and often are significant disparities between the two, and we need to routinely pause, take note, and acknowledge this. While initial cohesion is usual in a collective crisis, differences understandably surface. And when the institutional narrative eclipses the individual, or feels insistent, there is a real danger over time. Suppressed voices, unheard differing perspectives, and overshadowed individual experiences of traumatic impact impede a broader unifying movement forward. I believe an ongoing invitation for individual input can inform, enrich, guide, and ultimately support those in leadership roles.

For all of you, for each of you, I sincerely hope you feel accompanied. I hope we as a community and as individuals can both offer and partake of some refuge from time to time when wanted or needed.

Ellen Holly Aldrich is founding director, Center for Homicide Bereavement at Cambridge Health Alliance.

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